Early days of your preemie: at NICU and at Home

Premature babies show remarkable ability to survive and lead a normal and healthy life, even after being born premature and frail. Recent advances in the obstetric and neonatal care have improved the survival of even the smallest of the premature infants.1

NICU- the best place for preemies

Preemies, born before complete maturation, usually require specialized assistance in breathing or maintaining the body temperature. The best place for a delivery is a hospital with Neonatal Intensive Care Unit (NICU), equipped with all necessary resuscitative and rehabilitative measures.2

After the premature birth

Babies born before 37 weeks are immediately moved to the NICU for observation and specialized care. Accustomed to the maternal environment inside the womb, the baby is suddenly exposed to the external environment. This is the time when certain birth defects and complications of prematurity become apparent, and proper measures are taken.

Inside the NICU

The NICU would provide round-the-clock care to the newborn. Specialized care for your baby would include:

Warmth and Temperature regulation: Premature babies can be placed on an open bed with radiant warmer or an enclosed plastic incubator to maintain adequate body temperature. As the baby grows older, the mother is encouraged to provide kangaroo mother care, with skin-to-skin contact, to provide warmth and comfort to the baby.3

Nutrition and fluids: All infants must be exclusively fed on breast milk. Most babies more than 28 weeks have mature digestive tracts and are able to feed on breast milk. Few premature babies born earlier are not able to suck efficiently, or their digestive systems may not be mature enough to take oral feeds. Such infants are started on essential fluids and nutrients via a tube in a vein (intravenous feeding). Once these infants start gaining weight and are mature enough, intravenous feeds can be decreased and they too are started on breast milk.4

Testing and Laboratory procedures: The babies in the NICU are under continuous observation and undergo several tests to help monitor the baby's condition. Each infant has different needs and requires different tests like:

Blood grouping,

Testing for anemia (less hemoglobin),

Any infection,

Blood oxygen level,

Blood sugar or electrolytes level,

X rays to check condition of the lungs, heart or stomach are also done.5

Monitoring of vital signs: Sensors may be placed on the baby's body to check for the baby's heart rate, blood pressure, temperature, or amount of oxygen in the blood. Certain equipments like ultrasound, x-ray, Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) may be required for efficient monitoring of the baby's progress. Few small infants, with immature respiratory system may need a ventilator (breathing machine) with an external oxygen supply to help the baby breathe till maturity. At times, to treat certain babies suffering from jaundice, the babies need phototherapy care (light therapy to treat jaundice).5

Pro-developmental care: Developmental care has many benefits for the preemies, including better feeding, improved weight gain, shorter hospital stays, fewer complications, and a better parent-infant bonding. It includes a decrease in the noise and related stress to the babies, comfortable lighting conditions, and kangaroo mother care for the babies.6

Discharge from the NICU

The length of the baby's stay in the NICU usually depends on the prematurity and the health status of the baby. Most of the babies require hospitalization till the date they were supposed to be in the womb. However, this is an arbitrary assumption and requires a prompt treatment and further monitoring of the premature baby before he/she is discharged from the hospital.7

Support after discharge

The mother can continue to provide support and care to the baby. Routine follow-up appointments with the doctor and other health care professionals must be conducted according to the baby's needs.